Prospective follow-up study of borderline personality disorder: prognosis, prediction of outcome, and Axis II comorbidity.

Objective: To examine the rate of persistence of borderline personality disorder (BPD), the existence of concomitant personality disorders on follow-up, and the predictors of outcome in patients who met criteria for BPD compared with patients with borderline features who failed to meet all of the criteria.

Method: This prospective cohort study reassessed subjects for BPD diagnosis and cooccurring personality pathology at 7 years follow-up. Initial measures of borderline and comorbid personality psychopathology were used to predict levels of borderline or other personality disorder psychopathology at follow-up.

Developing effective services for patients with personality disorders.

Objective: This review focused on empirical research that addressed the effectiveness of service models for the care of patients with personality disorders.

Method: Services discussed included those delivering acute care, such as crisis and emergency services and acute psychiatric hospitalization; continuing care, such as outpatient services, day hospital treatment, and assertive community treatment programs; and other community programming, such as integrated treatment for comorbid substance abuse and psychoeducational interventions for families of patients with personality disorders. The review focused on studies that included patients with personality disorders, and it measured outcomes relevant to patients with personality disorders.

Radiation-induced tibial sarcoma in a treated case of hind foot angiomatosis.

Hemangiomatosis with osteolysis, osteosclerosis and loss of bony definition is an uncommon disease entity. Many forms of treatment have been used, varying almost from case to case. The use of radiation therapy has proved successful in the control of the disease process in reported cases.

Survey of factors influencing the selection of academic plastic surgeons.

The purpose of this study was to evaluate the importance of factors influencing the selection of candidates for academic positions in plastic surgery. This study reports the results of a survey investigating these factors. The survey was conducted in 1994, canvassing the chairpersons from the 120 plastic surgery programs in the United States and Canada with responses from 91 (76 percent) of the plastic surgery programs.

A composite silent corticotroph pituitary adenoma with interspersed adrenocortical cells: case report.

Objective And Importance: A case report of an extraordinary sellar pituitary tumor composed of corticotrophs and adrenocortical cells is presented. To our knowledge, this is only the second one reported in the literature.

Clinical Presentation: An 18-year-old female patient presented with amenorrhea.

Zoledronate (CGP 42'446), a bisphosphonate, protects against metaphyseal intracortical defects in experimental inflammatory arthritis.

This study investigated zoledronate (CGP 42'446), a bisphosphonate, as a potential prophylactic and therapeutic agent against intracortical defects in metaphyseal bone in an experimental model of inflammatory arthritis. Inflammatory arthritis was induced in the right tibiofemoral joint of rabbits by the repeated injection of carrageenan. Three groups of animals were treated with the bisphosphonate daily, beginning at different points after the induction of arthritis.

Laparoscopic splenectomy: lessons from the learning curve.

Objective: Initial reports suggest that laparoscopic splenectomy is a difficult procedure with a steep learning curve and limited scope. The objective of this study was to review various approaches to simplify the operation.

Design: A descriptive study of a prospective database.

Antibiotic therapy for abdominal infection.

Abdominal infections are treated by resuscitation, abdominal drainage, control of the source of infection, and antimicrobial agents. Ideally, antimicrobial therapy is active against expected pathogens, safe and effective in clinical trials, inexpensive, and unlikely to promote drug resistance. Numerous single-agent and combination-drug regimens have been efficacious in clinical trials, based on coverage of Escherichia coli and Bacteroides species, the predominant pathogens isolated.

Evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome. Pressure- and Volume-Limited Ventilation Strategy Group.

Background: A strategy of mechanical ventilation that limits airway pressure and tidal volume while permitting hypercapnia has been recommended for patients with the acute respiratory distress syndrome. The goal is to reduce lung injury due to overdistention. However, the efficacy of this approach has not been established.

Gaming: a teaching strategy to enhance adult learning.

Background: As a nurse educator, I encountered many complaints from staff nurses about mandatory inservice education programs, stating that they are repetitious, time-consuming, often too basic, and at times, downright boring. One exception was an Infection Control Week education session that was done in the form of a game. This session set attendance records and had very positive feedback from staff nurses.

Analysis of murine CD22 during B cell development: CD22 is expressed on B cell progenitors prior to IgM.

CD22 is a B cell-restricted glycoprotein involved in cell adhesion and signaling. Since CD22 is likely to play an important role in interactions between B cells and other cells, and in regulating signaling thresholds, we characterized the expression of murine CD22 during different stages of B cell development. In contrast to previous reports, we show that CD22 is expressed on B cell progenitors prior to expression of IgM.

Adynamic bone disease: pathogenesis, diagnosis and clinical relevance.

In the past several years significant attention has been directed to the study of adynamic bone disease in uremic patients. Several reports have provided additional information about the prevalence of adynamic bone disease in different countries. It has now become clear that the pathogenesis of adynamic bone disease cannot be ascribed to one single aetiological factor, but rather to a host of complex factors.

The influence of neurocognitive deficits and symptoms on quality of life in schizophrenia.

The purpose of the present study was to examine the relationship between neurocognitive deficits and self-reported quality of life in order to examine whether neurocognitive impairment interferes with any aspects of quality of life for patients with schizophrenia. Forty-two outpatients with stable chronic schizophrenia were assessed for neurocognitive deficits using a computerized test battery, and all patients completed a version of the Sickness Impact Profile (SIP) to assess their quality of life across a variety of domains. The neurocognitive assessment tests revealed significant deficits compared with normal control subjects, particularly with respect to impaired iconic memory and frontal functioning.

Group II phospholipases A2 are indirectly cytolytic in the presence of exogenous phospholipid.

Systemic inflammatory response syndromes including septic shock and salicylate poisoning are associated with high circulating levels of secretory phospholipase A2 (sPLA2). In septic shock, sPLA2 has been implicated in the pathogenesis of multisystem organ failure, presumably by a direct cytotoxic effect on cells. The cytotoxicity of recombinant human sPLA2 and a venom PLA2 were examined on human erythrocytes, erythroleukemia cells and U937 cells.

Anaphylactic shock induced by intraarticular injection of methylprednisolone acetate.

There are numerous reports of hypersensitivity reactions to corticosteroids. However, cases of anaphylactic shock after intraarticular injection of corticosteroids are exceedingly rare. We describe a case of anaphylaxis in a 31-year-old woman after intraarticular injection of synthetic methylprednisolone acetate.

Activation of CD8+ T lymphocytes in insulin-dependent diabetes mellitus.

Insulin-dependent diabetes mellitus (IDDM) is a T-cell-mediated autoimmune disease directed against the insulin-secreting beta cells of the islets of Langerhans of the pancreas. We have previously shown that in organ-specific autoimmune diseases, Graves' disease (GD), and IDDM, the antigen that is specific for each of these disorders (i.e.

Assessment and management of ocular foreign bodies.

Ocular trauma in sports is unexpected and can result in dramatic vision loss. Some of the most insidious yet serious ocular injuries result from retained intraocular foreign bodies, and therefore sports physicians, trainers, and emergency physicians should have a high degree of suspicion when evaluating sports- and work-related eye injuries. This article presents a stepwise approach to history, physical exam, management, and referral when intraocular foreign bodies are a possibility.

Experience With Nocturnal Hemodialysis.

In order to provide a highly efficient, long-duration form of hemodialysis, we developed nocturnal hemodialysis. Patients were dialyzed nightly at home for 8 - 10 hours, 6 - 7 nights/week. We kept the dialysate flow at 100 mL/min and the blood flow at 250 - 300 mL/min.

Central venous catheter management: how to prevent complications.

Central venous catheters (CVCs) are essential devices for providing dependable access in monitoring and management of both acutely and chronically ill patients. Increasingly, CVCs are the only available access options for renal patients due to the loss of viable peripheral access sites. Protocols for CVC change under sterile technique specific to our institution will be reviewed.